[Treatment of oncogenic emergencies in esophageal disease]

Nihon Geka Gakkai Zasshi. 2004 Apr;105(4):275-80.
[Article in Japanese]

Abstract

Common oncogenic emergent conditions of the esophagus are esophageal fistula with malignancy and peptic ulcer, perforation by a foreign body, and rupture (Boerhaave's syndrome) and bleeding with malignancy. The current standard of palliative therapy for patients with malignant tracheoesophageal fistula is endoscopic replacement using covered self-expandable metallic stents in the esophagus and/or trachea. We successfully treated two patients with esophageal bleeding caused by malignant ulceration. To prevent the formation of an aortoesophageal fistula, a covered self-expandable metallic stent was inserted into the esophagus and aorta. Insertion of covered self-expandable metallic stents in patients with esophageal malignancies significantly improves dysphagia, seals fistulas/perforations and ulcerations, and is associated with acceptable morbidity and mortality rates. Spontaneous esophageal rupture, also known as Boerhaave's syndrome, is a rare condition. Primary repair is appropriate for ruptures diagnosed early. Many are diagnosed late and T-tube drainage may be the simplest way to manage this difficult condition in this situation.

Publication types

  • Case Reports
  • English Abstract
  • Review

MeSH terms

  • Aged
  • Emergencies
  • Esophageal Diseases / complications
  • Esophageal Neoplasms / complications*
  • Esophageal Perforation / etiology
  • Esophageal Perforation / therapy*
  • Foreign Bodies / complications
  • Humans
  • Male
  • Middle Aged